The measurement of medial knee gap width using ultrasound.
The measurement of medial knee gap width using ultrasound.
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DOI：
10.1007/s00402-017-2740-9
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发表时间：
2017-08
影响因子：
2.3
通讯作者：
Scheys L
中科院分区：
文献类型：
--
作者：
Slane LC;Slane JA;Scheys L
内侧膝关节不稳定是评估韧带损伤和关节成形术成功的关键临床参数，但目前用于测量稳定性的方法通常是定性的或涉及电离辐射。本研究的目的是通过比较超声方法与模拟当前金标准透视方法的方法，对超声（US）是否可用作量化内侧不稳定的替代方法进行初步分析。收集内侧膝关节的US数据，同时对尸体下肢（n=8）施加外翻（10 Nm）载荷。在后处理期间，通过识别股骨和胫骨的内侧边缘并计算这些点之间的差距宽度来测量US间隙宽度。为了进行比较，模拟荧光透视（mFluoro）图像是从骨特异性骨模型创建的，从分段CT扫描和测试期间收集的运动学数据开发的。然后，基于两种不同的已发表方法，在mFluoro图像中测量间隙宽度，在股骨的最内侧或最远侧测量间隙宽度。间隙宽度随着载荷的增加而显著增加（p<0.001），超声方法（无载荷：8.7±2.4 mm，有载荷：10.7±2.2 mm）与测量股骨内侧间隙宽度的mFluoro方法之间无显著差异。就间隙宽度随载荷的变化而言，未观察到与外展角变化的相关性，各种方法之间也无相关性。US方法的评定者间可靠性较高（0.899-0.952）。超声显示出作为一种合适的替代方法来量化内侧不稳定性而无需辐射暴露的前景。然而，现有方法的突出局限性和缺乏真实的地面实况数据要求进一步的验证工作是必要的，以更好地了解用于测量内侧膝关节间隙宽度的US方法的临床可行性。
Medial knee instability is a key clinical parameter for assessing ligament injury and arthroplasty success, but current methods for measuring stability are typically either qualitative or involve ionizing radiation. The purpose of this study was to perform a preliminary analysis of whether ultrasound (US) could be used as an alternate approach for quantifying medial instability by comparing an US method with an approach mimicking the current gold standard fluoroscopy method. US data from the medial knee were collected while cadaveric lower limbs (n=8) were loaded in valgus (10 Nm). During post-processing, the US gap width was measured by identifying the medial edges of the femur and tibia and computing the gap width between these points. For comparison, mimicked fluoroscopy (mFluoro) images were created from specimen-specific bone models, developed from segmented CT scans, and from kinematic data collected during testing. Then, gap width was measured in the mFluoro images based on two different published approaches, with gap width measured either at the most medial or most distal aspect of the femur. Gap width increased significantly with loading (p<0.001), and there were no significant differences between the US method (unloaded: 8.7±2.4 mm, loaded: 10.7±2.2 mm) and the mFluoro method that measured gap width at the medial femur. In terms of the change in gap width with load, no correlation with the change in abduction angle was observed, with no correlation between the various methods. Inter-rater reliability for the US method was high (0.899–0.952). Ultrasound shows promise as a suitable alternative for quantifying medial instability without radiation exposure. However, the outstanding limitations of existing approaches and lack of true ground-truth data require that further validation work is necessary to better understand the clinical viability of an US approach for measuring medial knee gap width.
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DOI：
10.1097/01.blo.0000214421.21712.62
发表时间：
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